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Dietary Saturated Fatty Acids and Coronary Heart Disease Risk in a Dutch Middle-Aged and Elderly Population.
Arterioscler Thromb Vasc Biol 2016; 36(9):2011-8AT

Abstract

OBJECTIVE

We assessed whether the association between dietary saturated fatty acids (SFA) and incident coronary heart disease (CHD) depends on the food source, the carbon chain length of SFA, and the substituting macronutrient.

APPROACH AND RESULTS

From the Rotterdam Study, 4722 men and women (≥55 years) were included. Baseline (1990-1993) SFA intake was assessed using a validated food frequency questionnaire. CHD (nonfatal myocardial infarction and fatal CHD) was ascertained by medical records. Using multivariable Cox regression analysis, we calculated CHD risks for higher intakes of total SFA, SFA from specific food sources, SFA differing in carbon chain length, and substituting other macronutrients instead of SFA. During a median follow-up of 16.3 years, 659 CHD events occurred. Total SFA intake was not associated with CHD risk (hazard ratio [HR] per 5 en%, 1.13; 95% confidence interval, 0.94-1.22), and neither was SFA from specific food sources. A higher CHD risk was observed for palmitic acid (16:0) intake (HRSD, 1.26; 95% confidence interval, 1.05-1.15) but not for SFA with other chain lengths. Except for a higher CHD risk for substitution of SFA with animal protein (HR5en%, 1.24; 95% confidence interval, 1.01-1.51), substitution with other macronutrients was not associated with CHD.

CONCLUSIONS

In this Dutch population, we observed that a higher intake of palmitic acid, which accounts for ≈50% of the total SFA intake, was associated with a higher CHD risk, as was substitution of total SFA with animal protein. Nevertheless, we found no association between total SFA intake and CHD risk, which did not differ by food source.

Authors+Show Affiliations

From the Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands (J.P., J.W.J.B., I.S., Y.T.v.d.S.); Department of Epidemiology (E.A.L.d.J., J.C.K.-d.J., J.D.S., A.H., O.H.F.) and Department of Internal Medicine (E.A.L.d.J.), Erasmus Medical Center, Rotterdam, The Netherlands; Department of Global Public Health, Leiden University College, The Hague, The Netherlands (J.C.K.-d.J.); Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands (J.W.J.B.); and Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (A.H.).From the Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands (J.P., J.W.J.B., I.S., Y.T.v.d.S.); Department of Epidemiology (E.A.L.d.J., J.C.K.-d.J., J.D.S., A.H., O.H.F.) and Department of Internal Medicine (E.A.L.d.J.), Erasmus Medical Center, Rotterdam, The Netherlands; Department of Global Public Health, Leiden University College, The Hague, The Netherlands (J.C.K.-d.J.); Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands (J.W.J.B.); and Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (A.H.).From the Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands (J.P., J.W.J.B., I.S., Y.T.v.d.S.); Department of Epidemiology (E.A.L.d.J., J.C.K.-d.J., J.D.S., A.H., O.H.F.) and Department of Internal Medicine (E.A.L.d.J.), Erasmus Medical Center, Rotterdam, The Netherlands; Department of Global Public Health, Leiden University College, The Hague, The Netherlands (J.C.K.-d.J.); Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands (J.W.J.B.); and Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (A.H.). j.c.kiefte-dejong@erasmusmc.nl.From the Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands (J.P., J.W.J.B., I.S., Y.T.v.d.S.); Department of Epidemiology (E.A.L.d.J., J.C.K.-d.J., J.D.S., A.H., O.H.F.) and Department of Internal Medicine (E.A.L.d.J.), Erasmus Medical Center, Rotterdam, The Netherlands; Department of Global Public Health, Leiden University College, The Hague, The Netherlands (J.C.K.-d.J.); Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands (J.W.J.B.); and Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (A.H.).From the Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands (J.P., J.W.J.B., I.S., Y.T.v.d.S.); Department of Epidemiology (E.A.L.d.J., J.C.K.-d.J., J.D.S., A.H., O.H.F.) and Department of Internal Medicine (E.A.L.d.J.), Erasmus Medical Center, Rotterdam, The Netherlands; Department of Global Public Health, Leiden University College, The Hague, The Netherlands (J.C.K.-d.J.); Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands (J.W.J.B.); and Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (A.H.).From the Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands (J.P., J.W.J.B., I.S., Y.T.v.d.S.); Department of Epidemiology (E.A.L.d.J., J.C.K.-d.J., J.D.S., A.H., O.H.F.) and Department of Internal Medicine (E.A.L.d.J.), Erasmus Medical Center, Rotterdam, The Netherlands; Department of Global Public Health, Leiden University College, The Hague, The Netherlands (J.C.K.-d.J.); Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands (J.W.J.B.); and Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (A.H.).From the Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands (J.P., J.W.J.B., I.S., Y.T.v.d.S.); Department of Epidemiology (E.A.L.d.J., J.C.K.-d.J., J.D.S., A.H., O.H.F.) and Department of Internal Medicine (E.A.L.d.J.), Erasmus Medical Center, Rotterdam, The Netherlands; Department of Global Public Health, Leiden University College, The Hague, The Netherlands (J.C.K.-d.J.); Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands (J.W.J.B.); and Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (A.H.).From the Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands (J.P., J.W.J.B., I.S., Y.T.v.d.S.); Department of Epidemiology (E.A.L.d.J., J.C.K.-d.J., J.D.S., A.H., O.H.F.) and Department of Internal Medicine (E.A.L.d.J.), Erasmus Medical Center, Rotterdam, The Netherlands; Department of Global Public Health, Leiden University College, The Hague, The Netherlands (J.C.K.-d.J.); Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands (J.W.J.B.); and Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (A.H.).From the Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands (J.P., J.W.J.B., I.S., Y.T.v.d.S.); Department of Epidemiology (E.A.L.d.J., J.C.K.-d.J., J.D.S., A.H., O.H.F.) and Department of Internal Medicine (E.A.L.d.J.), Erasmus Medical Center, Rotterdam, The Netherlands; Department of Global Public Health, Leiden University College, The Hague, The Netherlands (J.C.K.-d.J.); Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands (J.W.J.B.); and Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (A.H.).

Pub Type(s)

Comparative Study
Journal Article
Observational Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

27417581

Citation

Praagman, Jaike, et al. "Dietary Saturated Fatty Acids and Coronary Heart Disease Risk in a Dutch Middle-Aged and Elderly Population." Arteriosclerosis, Thrombosis, and Vascular Biology, vol. 36, no. 9, 2016, pp. 2011-8.
Praagman J, de Jonge EA, Kiefte-de Jong JC, et al. Dietary Saturated Fatty Acids and Coronary Heart Disease Risk in a Dutch Middle-Aged and Elderly Population. Arterioscler Thromb Vasc Biol. 2016;36(9):2011-8.
Praagman, J., de Jonge, E. A., Kiefte-de Jong, J. C., Beulens, J. W., Sluijs, I., Schoufour, J. D., ... Franco, O. H. (2016). Dietary Saturated Fatty Acids and Coronary Heart Disease Risk in a Dutch Middle-Aged and Elderly Population. Arteriosclerosis, Thrombosis, and Vascular Biology, 36(9), pp. 2011-8. doi:10.1161/ATVBAHA.116.307578.
Praagman J, et al. Dietary Saturated Fatty Acids and Coronary Heart Disease Risk in a Dutch Middle-Aged and Elderly Population. Arterioscler Thromb Vasc Biol. 2016;36(9):2011-8. PubMed PMID: 27417581.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Dietary Saturated Fatty Acids and Coronary Heart Disease Risk in a Dutch Middle-Aged and Elderly Population. AU - Praagman,Jaike, AU - de Jonge,Ester A L, AU - Kiefte-de Jong,Jessica C, AU - Beulens,Joline W J, AU - Sluijs,Ivonne, AU - Schoufour,Josje D, AU - Hofman,Albert, AU - van der Schouw,Yvonne T, AU - Franco,Oscar H, Y1 - 2016/07/14/ PY - 2016/03/18/received PY - 2016/07/04/accepted PY - 2016/7/16/entrez PY - 2016/7/16/pubmed PY - 2017/6/14/medline KW - atherosclerosis KW - cholesterol KW - cohort studies KW - coronary disease KW - fatty acids SP - 2011 EP - 8 JF - Arteriosclerosis, thrombosis, and vascular biology JO - Arterioscler. Thromb. Vasc. Biol. VL - 36 IS - 9 N2 - OBJECTIVE: We assessed whether the association between dietary saturated fatty acids (SFA) and incident coronary heart disease (CHD) depends on the food source, the carbon chain length of SFA, and the substituting macronutrient. APPROACH AND RESULTS: From the Rotterdam Study, 4722 men and women (≥55 years) were included. Baseline (1990-1993) SFA intake was assessed using a validated food frequency questionnaire. CHD (nonfatal myocardial infarction and fatal CHD) was ascertained by medical records. Using multivariable Cox regression analysis, we calculated CHD risks for higher intakes of total SFA, SFA from specific food sources, SFA differing in carbon chain length, and substituting other macronutrients instead of SFA. During a median follow-up of 16.3 years, 659 CHD events occurred. Total SFA intake was not associated with CHD risk (hazard ratio [HR] per 5 en%, 1.13; 95% confidence interval, 0.94-1.22), and neither was SFA from specific food sources. A higher CHD risk was observed for palmitic acid (16:0) intake (HRSD, 1.26; 95% confidence interval, 1.05-1.15) but not for SFA with other chain lengths. Except for a higher CHD risk for substitution of SFA with animal protein (HR5en%, 1.24; 95% confidence interval, 1.01-1.51), substitution with other macronutrients was not associated with CHD. CONCLUSIONS: In this Dutch population, we observed that a higher intake of palmitic acid, which accounts for ≈50% of the total SFA intake, was associated with a higher CHD risk, as was substitution of total SFA with animal protein. Nevertheless, we found no association between total SFA intake and CHD risk, which did not differ by food source. SN - 1524-4636 UR - https://www.unboundmedicine.com/medline/citation/27417581/Dietary_Saturated_Fatty_Acids_and_Coronary_Heart_Disease_Risk_in_a_Dutch_Middle_Aged_and_Elderly_Population_ L2 - http://www.ahajournals.org/doi/full/10.1161/ATVBAHA.116.307578?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -